Emmanuel Eduardo Elizondo

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

856927 Issued in TX

Practice address

124 S US Highway 83 Unit 8
Zapata, TX 78076-3813

Phone

(956) 750-6592

NPI assigned

Oct 12, 2023

Last updated

Oct 12, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Divine Health Services LLC

  • Home Health Agency
  • Zapata, TX
  • NPI 1255104485
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1750162921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 S US HIGHWAY 83 UNIT 8",
            "city": "ZAPATA",
            "state": "TX",
            "postal_code": "780763813",
            "telephone_number": "956-750-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S US HIGHWAY 83 UNIT 8",
            "city": "ZAPATA",
            "state": "TX",
            "postal_code": "780763813",
            "telephone_number": "956-750-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "EMMANUEL",
        "middle_name": "EDUARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "856927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel's Pharmacy Inc (Daniel's Pharmacy #2)
• Daria Babineaux MD PA (The Pediatric Care Center)
• Del Mar Primary Home Care, LLC.
• Divine Health Services LLC
• El Parque Adult Day Care Inc
• Falcon Lake Health Care, LTD (Falcon Lake Nursing Home)
• Falcon Lake Health Care, LTD. (Falcon Lake Nursing Home)
• Falcon Lake Nursing Home, LLC
• Fortaleza Home Care, LLC
• Kaitlyn M Garcia, MS

• Administrator Registered Nurse in Zapata, TX
• Providers in Zapata, TX by specialty
• Administrator Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.